Psychiatry and the School of Medicine at the University of California, San Diego, San Diego, CA 92093, USA.
Acad Psychiatry. 2009 Nov-Dec;33(6):431-41. doi: 10.1176/appi.ap.33.6.431.
Whether and under what circumstances medical residents seek personal health care is a growing concern that has important implications for medical education and patient welfare, but has not been thoroughly investigated. Barriers to obtaining care have been previously documented, but very little empirical work has focused on trainees who seek health care at their home institution.
A self-report survey on special issues in personal health care of residents was created and distributed at the University of New Mexico School of Medicine in 2001. The authors report findings regarding stigma, fear of jeopardy to training status, and attitudes toward seeking self-care for residents in dual roles as patients and trainees.
Residents (N=155) rated their concerns regarding stigma and jeopardy to training status and the likelihood of seeking care at their training institution for six vignettes. The vignettes were paired to make comparisons between attending or supervisor as treating physician and between clinical scenarios. Alcohol abuse, nausea and diarrhea, panic attacks, and pregnancy were the most highly stigmatizing to residents; diabetes and hypertension were the least. Differences were also found for gender and specialty.
Residents' perceived stigma for clinical situations was an influential factor, strongly affecting concern about jeopardizing training status and likelihood of avoiding care at their home institution.
住院医师是否以及在何种情况下寻求个人医疗保健，是一个日益受到关注的问题，它对医学教育和患者福利都有重要影响，但尚未得到彻底调查。以前已经记录了获得医疗服务的障碍，但很少有实证工作关注在家属医疗机构寻求医疗保健的受训者。
2001 年，在新墨西哥大学医学院进行了一项关于住院医师个人保健特殊问题的自我报告调查。作者报告了关于住院医师在患者和受训者双重角色下寻求自我保健的耻辱感、对培训状态受损的恐惧以及对寻求自我保健的态度方面的发现。
住院医师（N=155）对六组情景剧中的耻辱感和对培训状态受损的担忧以及在培训机构寻求治疗的可能性进行了评分。这些情景被配对，以便在主治医生和临床情景之间进行比较。酒精滥用、恶心和腹泻、恐慌症发作和怀孕对住院医师的耻辱感最高；糖尿病和高血压的耻辱感最低。性别和专业也存在差异。
住院医师对临床情况的感知耻辱感是一个影响因素，强烈影响到对培训状态受损的担忧和避免在自家机构接受治疗的可能性。
